| NPI | 1053384750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0057722) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D005775) |
| 208M00000X Hospitalist (Licence: MD D57722) | |
| Enumeration Date | 2006-02-12 |
| Last Update Date | 2020-08-28 |